Project Summary Cancer screening is a complex, multi-step process where benefits are maximized when each step is completed successfully, but where sub-optimal outcomes are frequent as a result of breakdowns that can happen at any point in this process. Screening is also impacted by factors beyond simply individual patients?including factors at the provider-, practice-, and health plan/institution-level?and these so-called systems level factors can impact the appropriate delivery of high quality cancer screening services. PROSPR was established to address a number of critical questions related to the delivery of cancer screening in the United States, and our PROSPR I Statistical Coordinating Center was central to many of the successes of this initiative including: 1) Developing a trans-organ conceptual model of cancer screening processes, 2) Creating common data elements and screening performance metrics, 3) Evaluating individual and systems-level factors impacting screening performance, 4) Authorship and statistical support on 21 trans-network published papers, 2 under review, and 17 in preparation; and 5) Establishing PROSPR data repositories and creating an infrastructure for publicly sharing PROSPR data. Our PCC team has considerable expertise both in the leadership of large coordinating centers and in each of the scientific fields relevant to PROSPR including health services/health care delivery, implementation science, cancer epidemiology, health disparities research, biostatistics, bioinformatics/health information technology, and the screening of colorectal, cervical, and lung cancers. Thus, we are uniquely positioned to successfully execute all components of this coordinating center. The specific aims of our PCC are to: 1) Provide administrative coordination for the PROSPR network and guidance in the development of PROSPR?s governance, organization, and policies/procedures; 2) Lead the development of common conceptualization and measures for: A. Assessing the role of systems-level factors that impact the screening process. B. Assessing screening quality; 3) Facilitate trans-PROSPR research comparing the screening process across at least 2 organ sites; and 4) Develop and implement processes and procedures to share PROSPR data with qualified investigators outside of the PROSPR network. RELEVANCE: Improving both the screening process and screening quality for cervical, colorectal, and lung cancers will reduce mortality, morbidity, and health care costs associated with these cancers in the United States.